What do NICU nurses consider "viability"?

[Summers_Off]

I was taught in school that 26 weeks is viability. Is that viability in the real world? I know everyone wants full term, but if you or your wife was expecting, at what point in gestation would you exhale and feel confident in a good outcome if your baby were to be preterm?

Thanks for your response. I am very interested in knowing what professionals who see the good, the bad, and the ugly really think.The general public loves to share stories of the incredible ELBW miracles, but no one talks about the ELBW babies with profound disabilities. I precepted in the NICU but didn't get hired there after graduation. :-( Sure do miss it. I loved my time there. Such a special place with amazing nurses!

[AnnieOaklyRN, BSN, RN, EMT-P]

I know this is an older thread, but what would you guys recommend for pre-hospital. We don't have a scale or the experience to look at a baby and know what their gestational age is, we just don't see that enough.

Technically if the baby is said to be 22 weeks gestation or more we are to attempt resuscitation and contact medical control for further if we really think the baby is not viable. Its a tough call...

[Nicunurse14]

Ours 23 weeks

[guest769224]

My NICU dips to 22 weeks at times.

[Luckyyou, BSN, RN]

There is often a wide gap between what we as nurses consider viable and what our attendings/fellows do. Usually at the cost of great suffering to the kiddo.

[ScammRNC]

We do not attend deliveries of babies less than 23 weeks. If time allows, our neos visit with the parents and give them all the statistics on outcomes. We have decent outcomes with 24 weekers but of course would always rather see at 25 or 26 weeker if it is going to be early.

[nocturnalnurse]

I was looking at the website mentioned for outcomes calculation, and I think I have seen it before, but it appears the data was based off of evidence collected between 1998-2003? Not the most up to date, do you know of any source for calculations that is more recent?

I just entered in the lowest or first on all selections and this is what it says

"* These estimates are based on standardized assessments of outcomes at 18 to 22 months of infants born at NRN centers between 1998 and 2003...;"

[_firefly, BSN, RN, EMT-B]

This also depends on what a given facility is equipped for. You need a pretty high level nicu to support the really young ones (less than say 26 weeks).

[ScammRNC]

Our neo's will not attend any delivery of any infant

[babyNP., APRN]

I was looking at the website mentioned for outcomes calculation, and I think I have seen it before, but it appears the data was based off of evidence collected between 1998-2003? Not the most up to date, do you know of any source for calculations that is more recent?

I just entered in the lowest or first on all selections and this is what it says

"* These estimates are based on standardized assessments of outcomes at 18 to 22 months of infants born at NRN centers between 1998 and 2003...;"

Data is always about 10 years behind by the time it's published. This is the best out there, as far as I am aware.

[TiffyRN, BSN, PhD]

Data is always about 10 years behind by the time it's published. This is the best out there, as far as I am aware.

Here's a link to some more recent data from the NEJM. Sorry, it's only the abstract. It's so recent that I think I might only be able to get the full article if I put in a special request to my university library. I'll include a link to the HealthDay summary also.

Take home message; less mortality, more morbidity.

Ok, the NEJM article doesn't want to link. Here is the title:

Causes and Timing of Death in Extremely Premature Infants from 2000 through 2011

You can find it on the front page of NEJM dot org kind of near the bottom of the opening page.

HealthDay summary article:

More Extreme Preemies Are Surviving, Study Finds